Foucault and Feminist Philosophy of Disability is a multifaceted work that offers a compelling Foucauldian analysis of disability. Readers new to Shelley L. Tremain's work will find a thorough summary of concepts from Michel Foucault's later writings, clear explanations of how those concepts are useful for understanding disability, and applications of these analytic tools to debates within feminist philosophy and bioethics. For those who have followed Tremain's work, the book offers reflections that draw on her previous publications (indeed, many of the arguments here have been previously published), but in a unified and systematic way that is helpful for seeing the connections within her work, the context of her arguments, and the debates with which her writings have engaged. Tremain's overall argument that disability is an apparatus (in Foucault's sense of the term) is one that should be engaged by anyone interested in disability. (Indeed, taking this claim seriously means that many more philosophers should be interested in disability.)

Below, I will provide overviews of some of Tremain's main arguments, but let me begin by noting the productive ambiguity of the title. First, Tremain clearly believes that the use of Foucault's concepts furthers the aims of feminist philosophies of disability, that is, philosophies that aim to provide intersectional analyses of gender, disability, and other social identities in ways that resist oppression. But Tremain also defends Foucault, here, against claims by feminist scholars that his work is androcentric or that it cannot adequately account for embodiment. (In fact, she often turns the tables, suggesting that the feminist analyses in certain ways perpetuate ableism.) Third, using the critical lens Foucault offers, Tremain is critical of the way that philosophical analyses of disability are always understood within specific subdisciplines like "feminist philosophy of disability" or "feminist bioethics," such that disability becomes an "applied" topic, not one that is philosophically interesting in its own right.

This third theme is a key concern of the preface. Here, Tremain points out, for example, that in 2013, the PhilPapers database listed disability only as a topic of philosophical research under the heading "Feminism: Disability," itself a subcategory of "Topics in Feminist Philosophy," which was a subcategory of "Philosophy of Gender, Race, and Sexuality," which was a subcategory of "Value Theory." (She does note that this has changed, but is skeptical that the changes are sufficient.) This is shocking because disability theorists have always been concerned with metaphysical and epistemological questions (understanding what disability is and whose knowledge of disability counts), or, perhaps more to the point, with problematizing the distinctions between questions of value and metaphysical or epistemological questions. Categorizing philosophical engagements with disability in this way reinforces the view of disability as an applied topic, and this contributes to other tendencies in academic philosophy, such as viewing disability as a medical (rather than say, a political or metaphysical) problem, failing to take research on disability as seriously as research on more established or "universal" problems in philosophy, and failing to make academic spaces accessible for disabled philosophers.

In the first chapter, "Groundwork for a Feminist Philosophy of Disability," Tremain introduces what she calls "two spheres of analysis." The "reconstructive-conceptual sphere" aims to develop an understanding of disability as culturally and historically contingent rather than as a transhistorical, biological, given "impairment." The "metaphilosophical sphere" seeks to understand how and why the philosophy of disability and disabled philosophers have been excluded from, or at best marginalized within, the discipline of philosophy. To be sure, these spheres intersect. The understanding of disability as an impairment contributes to the rejection of disability as a philosophically interesting area of research; and the exclusion of disability as an area of research and the exclusion of disabled philosophers from academia silence or marginalize research that understands disability as anything other than impairment. But naming these two spheres at the beginning enables Tremain to track these lines of argument and their intersections throughout the book.

This chapter also introduces Tremain's argument that disability is an "apparatus," that is, "a historically specific and dispersed system of power that produces and configures practices toward certain strategic and political ends" (21). One can see that as historically specific, productive, and political, understanding disability as an apparatus differs in significant ways from understanding disability or impairment as transhistorical, given, or prepolitical. For Tremain, this provides an important corrective to even many other social models of disability. This is because many such models do recognize that disability is produced socially (whether as a functional impairment brought about by social and material conditions or as a form of social discrimination), but account for this by claiming that there is an underlying impairment, or biological condition, that becomes a disability in interaction with certain social conditions. Such accounts fail to capture how impairments themselves are historically contingent and produced by forms of knowledge, testing procedures, social, scientific, and moral norms, architectural decisions, and so on. But impairments are not just the result of these forces; impairment itself becomes a "mechanism of the apparatus of disability" (21) insofar as these forces establish impairments as prediscursive or natural such that we become unaware of the ways in which impairments are constituted. In other words, the relationships of forces within the apparatus of disability give rise to impairment as a naturalized object, and so naturalized, impairment justifies the continuing functioning of disability as an apparatus.

A micro-scale example is the discipline of philosophy itself. Within the discipline, those who seek to study disability have great incentives to do so under the heading of "bioethics," as this is a growing field with readily available job opportunities, publication venues, grant funding, and so on. However, insofar as mainstream bioethics treats impairment as a natural defect to which we as a society should respond in moral ways, bioethics as a subdiscipline participates in naturalizing impairment. In this way, philosophical questions about disability are tracked into medicalizing, naturalizing discourses to the neglect of alternative interpretations of what disability is.

The first chapter also introduces data about the exclusion of disabled persons from employment in US and Canadian universities and offers reflections upon the ableist language (such as "blind review" and "justice is blind") that circulates within society more broadly. Noting that her criticisms of these linguistic practices have been opposed in the past, Tremain introduces the term "ableist exceptionism" to name the ways in which critical inquiries that seek to recognize and address social injustices often exclude disability as a lens of analysis (in large part because disability is seen as a prediscursive defect, whereas gender and race are recognized as social).

The chapter ends with reflections on social epistemology. Tremain is critical, here, of Miranda Fricker's use of the example of a person with a condition causing socially unacceptable behavior to draw a distinction between "circumstantial bad luck" and hermeneutical injustice (39-40). What Fricker fails to account for, according to Tremain, are the ways in which people whose behavior is deemed socially unacceptable (such as those labeled mentally ill) are afforded unequal opportunities for hermeneutical participation in ways similar to the examples of gender and race Fricker relies upon to develop her understanding of hermeneutical injustice. Indeed, Fricker's failure to consider the claims and arguments of disabled people "seems itself to be an instance of epistemic injustice" (41).

The second chapter, "Power and Normalization," is a clear and helpful overview of Foucault's concepts as they relate to the apparatus of disability, as well as concepts from Ian Hacking and Ladelle McWhorter that develop from Foucauldian analyses. The concepts discussed include "discourse," "normation," "genealogy," "racism against the abnormal," "governmentality," "subjectivity," and Hacking's "styles of reasoning." Her understandings of "biopower," "normalization," and power as individualizing and totalizing are especially important to later chapters. Biopower is a form of power whose aim is the management of the life of a population. Understanding biopower is important for Tremain, because it is only once the life of a population becomes an object of concern that disability can become a site of knowledge and intervention (whether through public health campaigns, studies of health risk, insurance programs, controlling reproduction, and so on). One important technology of biopower is "normalization," the practice of dividing populations according to deviations from a norm in order to correct the "anomalies" or otherwise protect the population from them. A result of normalization is that subjects come to understand themselves according to the scientific classifications with which they have been associated. To understand how power functions today, then, we must understand that power works through both "individualization," linking individuals to certain identities, and "totalization," the relation of those identities to one another through rankings, hierarchies, and so on. When these forces work together most efficiently, individuals think of themselves in these terms, appearing to make free choices without recognizing that they are choosing from a limiting array of normalizing possibilities.

In the third chapter, "Historicizing and Relativizing Philosophy of Disability," Tremain responds to disability theorists who worry that using Foucault's concepts to understand disability is misguided. She identifies two main concerns here: first, that Foucault's concept of subjectivity is too "thin" to render it politically useful; second, that Foucault neglects the body and borders on a sort of linguistic idealism. To begin the chapter, Tremain offers a more detailed discussion of how her own account differs from other models of disability, developing the sketch from the first chapter. Through the functioning of disability as an apparatus of biopower, impairments become naturalized, and disabled people come to understand themselves in these terms. One worry, then, is that Tremain's account seems to limit the extent to which we can draw on the experiences and testimonies of disabled persons, since those experiences are themselves conditioned by the workings of power. Here, she introduces an important distinction. Experience, she says, should be treated as "that for which explanation is sought" rather than the "authoritative evidence that grounds what is already known" (106). For example, taking a historical perspective, one might ask, "How does normalization serve as a condition of possibility for understanding and experiencing myself as a person with ADHD?" rather than making transhistorical claims like, "This is what it is like to have ADHD." The point is not that there is no reality to the experience, but rather that the reality of that experience is historically contingent, and that to ignore this fact is to risk reifying the naturalized, medicalized account of what ADHD is and to potentially lose possibilities for "personal and social transformation" (107). Thus, a Foucauldian account of disability should enable the political subjectivity of disabled persons, not hinder it.

The second half of the chapter addresses claims that Foucault neglects the body. Drawing upon debates within feminist scholarship about the sex-gender distinction, Tremain argues that we must resist the temptation to think of bodies, impairments, sex, or nature in general as separable from culture, language, or the workings of power. Impairment cannot be understood apart from disability, just as, following Judith Butler and others, sex cannot be understood apart from gender. Indeed, Foucault emphasizes the extent to which power operates on and through bodies, but these operations of power give rise to certain types of bodies, they shape the body and one's experiences, such that one cannot expect to peel down through the layers of discourse or power and find the "real" body.

The fourth chapter responds to some worries about Foucault's theories expressed by feminist authors. Tremain deals quickly with the first concern--that Foucault focuses on sex and sexuality to the neglect of gender--by showing that, though he may not use the word "gender," he does clearly engage with aspects of what we currently understand as gender, especially in his discussions of the hysterization of women. The remainder of the chapter is a close consideration of worries that Foucault has androcentric biases and that he is insensitive to the seriousness of rape, most notably through his use of the case of Charles Jouy (a farmhand of about forty years of age, classified as an imbecile) and Sophie Adam (a girl from the same village who engaged in sexual activity with Jouy). According to what Tremain calls the "accepted feminist interpretation," Foucault's use of the example in his analysis demonstrates a masculinist insensitivity to girls' and women's experiences of rape, and Foucault fails to take seriously that Jouy was in a position of power over Adam and that their interactions amount to sexual abuse or rape. Contrary to these interpretations, Tremain argues that Foucault was in fact sensitive to experiences of rape (indeed, she offers other textual evidence that he took the injustice of rape quite seriously), and that there is insufficient evidence to claim that the interaction between Jouy and Adam was necessarily the sexual abuse of Adam by Jouy. Indeed, she suggests that, given other textual evidence, it might well have been the case that it was Adam who took advantage of Jouy, a possibility that proponents of the accepted feminist interpretation miss because of assumptions about the transhistorical nature of power relations between ages and genders, failure to take seriously the experiences of disabled persons, and assumptions about their ability to understand ableism based on experiences of sexism.

In the final chapter, "Bioethics as a Technology of Government," Tremain seeks to put the subdiscipline of "bioethics" in historical context and, using this context, to demonstrate the ways in which bioethicists participate in the apparatus of disability. Taking as examples discussions of reproductive screening technologies and stem cell research, Tremain shows how mainstream (even feminist) arguments within bioethics leave unquestioned the desirability of screening for certain conditions or developing stem cell treatments to "cure" certain conditions. That is, they treat impairments themselves as natural (and naturally undesirable), and in doing so reproduce and participate in understandings of those conditions as natural and undesirable. This in turn justifies the uses of these technologies, further naturalizing the impairments they are used to "treat." To be clear, Tremain is careful to clarify that according to Foucault, modern power is intentional (that is, it serves certain ends) but nonsubjective (that is, we cannot always point to a decision-maker, a guiding person or group of persons directing the uses of power). Thus, we need not believe bioethicists are intentionally using the field to further certain aims of biopower to understand how bioethics does have certain effects that further the aims of biopower.

Foucault and Feminist Philosophy of Disability offers exciting and thoughtful arguments that contribute to the philosophy of disability, feminist philosophy, and our understanding of philosophy as an academic discipline. Many of Tremain's arguments are far too nuanced for me to do justice to in the space of this review, but I hope to have given potentially interested readers an idea of what to expect and evidence that the book is well worth a thorough reading.

Josh Dohmen is Assistant Professor of philosophy at Mississippi University for Women. His research interests include twentieth-century continental philosophy, philosophy of disability, and feminist epistemology. His publications include "Interactions with Delusional Others: Reflections on Epistemic Failures and Virtues," forthcoming in the Oxford Handbook of Philosophy and Disability, and "Disability as Abject: Kristeva, Disability, and Resistance." His article "'A Little of Her Language': Epistemic Injustice and Mental Disability" was awarded Res Philosophica's 2016 essay prize.

"Tremain is critical of the way that philosophical analyses of disability are always understood within specific subdisciplines like 'feminist philosophy of disability' or 'feminist bioethics,' such that disability becomes an 'applied' topic, not one that is philosophically interesting in its own right."